摘要
目的探讨血小板/高密度脂蛋白胆固醇比值(PHR)对2型糖尿病(T2DM)患者糖尿病足溃疡(DFU)的预测价值。方法回顾性纳入2024年1月至2025年3月在吉林省人民医院内分泌科收治的T2DM患者共295例,根据是否发生DFU分为单纯T2DM组(148例)和DFU组(147例),DFU组患者再根据Wagner分级标准分为3组:Wagner1~2级为轻度DFU组(48例),Wagner3级为中度DFU组(49例),Wagner4~5级为重度DFU组(50例)。比较四组患者在一般资料、临床指标、PHR之间的差异。采用Spearman相关性分析评价PHR与Wagner分级的相关性。采用多因素Logistic回归分析确定PHR与T2DM患者发生DFU的独立相关性。采用受试者工作特征(ROC)曲线评估PHR对T2DM患者DFU发生的诊断效能。结果DFU各组的PHR均高于单纯T2DM组,重度DFU组PHR明显高于轻度和中度DFU组(P<0.05)。PHR与白细胞计数(r=0.499)、血小板计数(r=0.771)、中性粒细胞计数(r=0.449)、单核细胞计数(r=0.379)均呈正相关(P<0.01),PHR与AST(r=-0.127)、血白蛋白(r=-0.418)、总胆固醇(r=-0.332)、高密度脂蛋白胆固醇(r=-0.686)、低密度脂蛋白胆固醇(r=-0.198)、血红蛋白(r=-0.275)均呈负相关(P<0.05)。多因素Logistic回归分析结果显示,PHR与DFU的发生存在显著相关性,PHR[OR=1.007(95%CI:1.001~1.013)]是发生DFU的独立危险因素(P<0.05)。ROC曲线分析显示,PHR预测DFU的曲线下面积为0.710,最佳截断值为269.585(×10^(3)cells/μL),对应的灵敏度和特异度分别为60.5%和71.6%。结论PHR与T2DM患者并发DFU密切相关,对T2DM并发DFU的风险有预测价值。
Objective To investigate the predictive value of the platelet to high-density lipoprotein cholesterol ratio(PHR)for diabetic foot ulcer(DFU)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 295 T2DM patients admitted to the Department of Endocrinology,Jilin Provincial People's Hospital from January 2024 to March 2025 were retrospectively enrolled.Based on the presence or absence of DFU,patients were classified into a T2DM group(n=148)and a DFU group(n=147).Patients in the DFU group were further categorized into three subgroups according to the Wagner grading system:Wagner grades 1~2 as the mild DFU group(n=48),Wagner grade 3 as the moderate DFU group(n=49),and Wagner grades 4~5 as the severe DFU group(n=50).Differences in general characteristics,clinical indicators,and PHR among the four groups were compared.Spearman correlation analysis was used to evaluate the correlation between PHR and Wagner grade.Multivariate logistic regression analysis was performed to determine the independent association between PHR and DFU occurrence in T2DM patients.Receiver operating characteristic(ROC)curve analysis was applied to assess the diagnostic efficacy of PHR for DFU in T2DM patients.Results PHR in all DFU subgroups was higher than that in the T2DM group,and PHR in the severe DFU group was significantly higher than that in the mild and moderate DFU groups(P<0.05).PHR showed positive correlations with white blood cell count(r=0.499),platelet count(r=0.771),neutrophil count(r=0.449),and monocyte count(r=0.379)(all P<0.01).PHR was negatively correlated with aspartate aminotransferase(r=-0.127),serum albumin(r=-0.418),total cholesterol(r=-0.332),high-density lipoprotein cholesterol(r=-0.686),low-density lipoprotein cholesterol(r=-0.198),and hemoglobin(r=-0.275)(all P<0.05).Multivariate Logistic regression analysis revealed that PHR was significantly associated with DFU occurrence,with PHR[OR=1.007(95%CI:1.001~1.013)]identified as an independent risk factor for DFU(P<0.05).ROC curve analysis indicated that the area under the curve for PHR in predicting DFU was 0.710,with an optimal cut-off value of 269.585(×10^(3)cells/μL),corresponding to a sensitivity of 60.5%and a specificity of 71.6%.Conclusion PHR is closely associated with DFU in T2DM patients and has predictive value for the risk of DFU in this population.
作者
李汇溪
刘红梅
柴思扬
祁冰雪
杨乐
LI Huixi;LIU Hongmei;CHAI Siyang;QI Bingxue;YANG Le(Department of Clinical Medicine,Changchun University of Traditional Chinese Medicine,Changchun 130117,China;Endocrinology Department,Jilin Provincial People's Hospital,Changchun 130021,China)
出处
《中国实验诊断学》
2026年第2期194-199,共6页
Chinese Journal of Laboratory Diagnosis
基金
吉林省科技发展计划项目(20250205007GH)。
关键词
2型糖尿病
糖尿病足溃疡
血小板计数
高密度脂蛋白胆固醇
血小板与高密度脂蛋白胆固醇比值
预测价值
Type 2 diabetes mellitus
Diabetic foot ulcer
Platelet count
High-density lipoprotein cholesterol
Platelet to high-density lipoprotein cholesterol ratio
Predictive value
